The reliability, precision and clinically meaningful change of walking assessments in multiple sclerosis

2013 ◽  
Vol 19 (13) ◽  
pp. 1784-1791 ◽  
Author(s):  
Yvonne C Learmonth ◽  
Deirdre D Dlugonski ◽  
Lara A Pilutti ◽  
Brian M Sandroff ◽  
Robert W Motl
Keyword(s):  
Multiple Sclerosis ◽  
Intraclass Correlation ◽  
Important Change ◽  
Minimal Detectable Change ◽  
Walking Aids ◽  
Clinically Important Change ◽  
Standard Error Of Measurement ◽  
Disability Level ◽  
Minute Walk ◽  
Error Of Measurement

Background: Assessing walking impairment in those with multiple sclerosis (MS) is common, however little is known about the reliability, precision and clinically important change of walking outcomes. Objective: The purpose of this study was to determine the reliability, precision and clinically important change of the Timed 25-Foot Walk (T25FW), Six-Minute Walk (6MW), Multiple Sclerosis Walking Scale-12 (MSWS-12) and accelerometry. Methods: Data were collected from 82 persons with MS at two time points, six months apart. Analyses were undertaken for the whole sample and stratified based on disability level and usage of walking aids. Intraclass correlation coefficient (ICC) analyses established reliability: standard error of measurement (SEM) and coefficient of variation (CV) determined precision; and minimal detectable change (MDC) defined clinically important change. Results: All outcome measures were reliable with precision and MDC varying between measures in the whole sample: T25FW: ICC=0.991; SEM=1 s; CV=6.2%; MDC=2.7 s (36%), 6MW: ICC=0.959; SEM=32 m; CV=6.2%; MDC=88 m (20%), MSWS-12: ICC=0.927; SEM=8; CV=27%; MDC=22 (53%), accelerometry counts/day: ICC=0.883; SEM=28450; CV=17%; MDC=78860 (52%), accelerometry steps/day: ICC=0.907; SEM=726; CV=16%; MDC=2011 (45%). Variation in these estimates was seen based on disability level and walking aid. Conclusion: The reliability of these outcomes is good and falls within acceptable ranges. Precision and clinically important change estimates provide guidelines for interpreting these outcomes in clinical and research settings.

scholarly journals Reliability of three-dimensional kinematic gait data in adults with spinal cord injury

2017 ◽  
Vol 4 ◽  
pp. 205566831772999 ◽  
Author(s):  
Pia Wedege ◽  
Kathrin Steffen ◽  
Vegard Strøm ◽  
Arve Isak Opheim
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Cord Injury ◽  
Hip Rotation ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Objectives Three-dimensional gait analysis has been recommended as part of standardized gait assessment in people with spinal cord injury. The aim was to investigate inter- and intra-session reliabilities of gait kinematics in people with spinal cord injury. Methods Fifteen adults with spinal cord injury performed two test sessions on separate days. Six infrared cameras, 16 reflective markers and the Plug-in gait model were used. For each subject, five gait trials from both sessions were included. The Gait Profile Score and the Gait Variable Score were used as kinematic outcome measures. Reliability was assessed with intraclass correlation coefficient, standard error of measurement, minimal detectable change, and Bland–Altman plots. Results Inter-session intraclass correlation coefficient for all variables was >0.82 and standard error of measurement <1.8°, except for hip rotation. Intra-session reliability was found to be high (≥0.78) and slightly better than that for inter-session. Minimal detectable change for all variables was <4.7°, except for hip rotation. Conclusions The high inter- and intra-session reliabilities indicate small intrinsic variation of gait. Thus, three-dimensional gait analysis seems to be a reliable tool to evaluate kinematic gait in adults with spinal cord injury, but caution is warranted especially for hip rotation evaluation.

scholarly journals Methodological and interpretive concerns about Beemster et al.’s article ‘The interpretation of change score of the pain disability index after vocational rehabilitation is baseline dependent’: a letter to the editor

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Laura Wilma Maria Elisabeth Beckers ◽  
Rob Johannes Elise Marie Smeets
Keyword(s):  
Vocational Rehabilitation ◽  
Intraclass Correlation ◽  
Change Score ◽  
Important Change ◽  
Minimal Important Change ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Standard Error Of Measurement ◽  
Interpretation Of Change ◽  
Error Of Measurement

Abstract This is a critique of Beemster et al.’s article ‘The interpretation of change score of the pain disability index after vocational rehabilitation is baseline dependent’ (2018). The methodological issues in question include the choices of anchor to determine the minimal important change, and the intraclass correlation coefficient on which the calculation of the standard error of measurement was based. We believe these undermine the authors’ interpretation.

scholarly journals Test-retest reliability of a smartphone app for measuring core stability for two dynamic exercises

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7485 ◽  
Author(s):  
Paloma Guillén-Rogel ◽  
Cristina Franco-Escudero ◽  
Pedro J. Marín
Keyword(s):  
Intraclass Correlation ◽  
Dynamic Exercise ◽  
Core Stability ◽  
Smartphone App ◽  
Minimal Detectable Change ◽  
Exercise Tests ◽  
Minimum Detectable Difference ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

Background Recently, there has been growing interest in using smartphone applications to assess gait speed and quantify isometric core stability exercise intensity. The purpose of this study was to investigate the between-session reliability and minimal detectable change of a smartphone app for two dynamic exercise tests of the lumbopelvic complex. Methods Thirty-three healthy young and active students (age: 22.3 ± 5.9 years, body weight: 66.9 ± 11.3 kg, height: 167.8 ± 10.3 cm) participated in this study. Intraclass correlation coefficient (ICC), coefficient of variation (%CV), and Bland–Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD) were calculated for clinical applicability. Results The ICCs ranged from 0.73 to 0.96, with low variation (0.9% to 4.8%) between days of assessments. The Bland–Altman plots and one-sample t-tests (p > 0.05) indicated that no dynamic exercise tests changed systematically. Our analyses showed that SEM 0.6 to 1.5 mm/s-2) and MDD (2.1 to 3.5 mm/s-2). Conclusion The OCTOcore app is a reliable tool to assess core stability for two dynamic exercises. A minimal change of 3.5 mm/s-2 is needed to be confident that the change is not a measurement error between two sessions.

Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson
Keyword(s):  
Multiple Sclerosis ◽  
Measurement Errors ◽  
Balance Control ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.

scholarly journals Reliability of an isometric test for measuring the strength of the hip abductors and adductors

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Manoella Regina de Souza Silva ◽  
Thiago Keitiney Souza Teixeira Da Silva ◽  
Valdemi Xavier Delmondes Junior ◽  
Silvia Ribeiro Santos Araújo ◽  
Adriano Percival Calderaro Calvo ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Complex Structures ◽  
Hip Joints ◽  
Physically Active ◽  
Adductor Muscles ◽  
Hip Abduction ◽  
Standard Error Of Measurement ◽  
Dynamic Variables ◽  
Error Of Measurement ◽  
Familiarization Procedure

This study aimed to measure the reliability of a test for measuring the strength and strength imbalance of the hip abductors and adductors, using isokinetic equipment adapted for isometric testing. Thirteen healthy, physically active male individuals took part in the research. Two unilateral isometric tests were undertaken using a load cell attached to an adapted abductor bench machine: a hip abduction test and hip adduction test. Tests consisted of two maximum voluntary isometric contractions made for six seconds with a break of one minute between each. The following dynamic variables were measured: maximum force, mean force, rate of force development for each limb (right and left), and the existence of asymmetries between the limbs. For statistical analysis, the t-test, intraclass correlation coefficient (ICC), and standard error of measurement (SEM) were applied. Results: The methodology utilized for the evaluation of the hip abductors and adductors did not show reliability in most of the parameters researched, with the ICC neither sufficient or low, and the retest performance higher than the test (p < 0.05). The applied test was not reliable for assessing strength and strength imbalances of hip abductors and adductors in most of the parameters investigated. These results indicate that the hip joints, more precisely, the abductor and adductor muscles, are complex structures to be assessed. They need to be previously familiarized with the proposed exercise, as their performance does not occur habitually. It is recommended to develop new tests in order to measure hip abduction and adduction strength adding a prior familiarization procedure.

scholarly journals Case Report: Combining Dalfampridine with Multicomponent Exercise and Gait Training in a Person with Multiple Sclerosis

2018 ◽  
Vol 20 (5) ◽  
pp. 238-243
Author(s):  
Prudence Plummer ◽  
Corinne J. Bohling ◽  
L. Ellese Nickles ◽  
Alexis A. Williams ◽  
Amy Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Dual Task ◽  
Gait Speed ◽  
Gait Training ◽  
Important Change ◽  
Relapsing Remitting ◽  
History Of ◽  
Task Conditions ◽  
Clinically Important Change

Abstract Background: Dalfampridine extended release (D-ER) improves gait speed in some people with multiple sclerosis (MS), but many patients who take D-ER demonstrate only small improvements of questionable clinical significance. Physical therapy (PT) may augment the treatment effects of D-ER on the nervous system and improve clinical outcomes. This case report describes the successful use of D-ER combined with multicomponent PT in a patient who did not have a clinically important change in gait speed with D-ER alone. Methods: A 59-year-old woman with a 6-year history of relapsing-remitting MS was prescribed D-ER by her neurologist. After 3 weeks of D-ER therapy (10 mg twice daily), she demonstrated only a 7.1% improvement in the Timed 25-Foot Walk test. She then commenced PT consisting of two 40-minute sessions per week for 6 weeks while continuing D-ER therapy. Training focused on gait, balance, coordination, functional strengthening, and dual-task performance. Results: After 6 weeks of D-ER + PT, she had a further 14.6% improvement in Timed 25-Foot Walk gait speed, for a total improvement of 20.7%, which elevated her above the clinically meaningful threshold of 20%. Similar patterns of improvement were also observed for self-selected gait speed in single- and dual-task conditions. Improvements in fast and dual-task gait speed were retained 3 weeks later. Conclusions: For this patient, combining PT with D-ER therapy improved gait speed more than the use of D-ER alone. Further investigation of D-ER + PT or PT as an alternative to D-ER in patients with submeaningful medication response is warranted.

Assessment of Knee Laxity Following Anterior Cruciate Ligament Reconstruction

1993 ◽  
Vol 2 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Kelly R. Holcomb ◽  
Cheryl A. Skaggs ◽  
Teddy W. Worrell ◽  
Mark DeCarlo ◽  
K. Donald Shelbourne
Keyword(s):  
Anterior Cruciate Ligament ◽  
Standard Error ◽  
Cruciate Ligament ◽  
Intraclass Correlation ◽  
Knee Laxity ◽  
Testing Procedures ◽  
Kt 1000 ◽  
Anterior Cruciate ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

A paucity of information exists concerning reliability of the KT-1000 knee arthrometer (MEDmetric Corp., San Diego, CA) when used by different clinicians to assess the same anterior cruciate ligament-deficient patient. The purpose of this study was to determine the reliability and standard error of measurement of four clinicians who routinely report KT-1000 arthrometer values to referring orthopedic surgeons. Two physical therapists and two athletic trainers performed anterior laxity tests using the KT-1000 on 19 subjects. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to determine reliability. Intratester ICC ranged from .98 to 1.0 and intratesterSEMranged from 0.0 to .28 mm. Intertester ICC andSEMfor all four testers were .53 and 1.2 mm, respectively. A 95% confidence interval (M ± 1.96 ×SEM) of the intertester variability ranged from −0.18 to 4.52 mm. Therefore, large intertester variation existed in KT-1000 values. Each facility should standardize testing procedures and establish intratester and intertester reliability for all clinicians reporting KT-1000 values.

Test–Retest Reliability of Skill Tests in the F-MARC Battery for Youth Soccer Players

2019 ◽  
Vol 126 (5) ◽  
pp. 1006-1023 ◽  
Author(s):  
Alexis Padrón-Cabo ◽  
Ezequiel Rey ◽  
Alexandra Pérez-Ferreirós ◽  
Anton Kalén
Keyword(s):  
Intraclass Correlation ◽  
Young Male ◽  
Soccer Players ◽  
Limits Of Agreement ◽  
Retest Reliability ◽  
Youth Soccer ◽  
Test Retest Reliability ◽  
Standard Error Of Measurement ◽  
Absolute Reliability ◽  
Error Of Measurement

This study aimed to evaluate the test–retest reliability of soccer skill tests belonging to the F-MARC test battery. To avoid bias during talent identification and development, coaches and scouts should be using reliable tests for assessing soccer-specific skills in young male players. Fifty-two U-14 outfield male soccer players performed F-MARC soccer skill tests on two occasions, separated by 7 days. After familiarization, we administered two trial sessions of five skill tests: speed dribbling, juggling, shooting, passing, and heading. We assessed absolute reliability by expressing the standard error of measurement as a coefficient of variation with 95% limits of agreement, and we assessed relative reliability with the intraclass correlation coefficient and with Pearson’s correlation ( r). The results demonstrated satisfactory relative and absolute reliability for speed dribbling, right foot juggling, short passing, shooting a dead ball right, shooting from a pass, heading in front, and heading right. However, reliability values for left foot juggling, chest-head-foot juggling, head-left-foot-right foot-chest-head juggling, long pass, and shooting a dead ball left tests were not strong enough to suggest their usage by coaches in training or sport scientists in research.

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